Ohio gets OK from Trump administration to mandate work for able-bodied Medicaid recipients

By Catherine Candisky ccandisky@dispatch.com

Friday

Mar 15, 2019 at 1:25 PMMar 18, 2019 at 1:09 PM

Federal regulators have approved Ohio’s request to require thousands of Medicaid recipients to work, attend classes or training for a job to qualify for benefits.

The federal Centers for Medicare and Medicaid Services notified state officials that they could impose work requirements on able-bodied adults up to age 50 enrolled in the tax-funded health insurance program.

Ohio is the ninth state to get permission to mandate work for certain Medicaid beneficiaries. So far, only Arkansas, Indiana and New Hampshire have implemented the requirement.

Critics say thousands of poor Ohioans will lose Medicaid coverage for failing to meet the requirements which they argue are unfair to those in low-wage jobs with hours that often vary week to week.

In Arkansas, 18,000 have lost coverage since the state implemented work requirements last July for adults up to age 50. Indiana and New Hampshire are still phasing in their programs.

In its two-year budget proposal released Friday, the DeWine administration projects Ohio Medicaid enrollment to increase even with the work requirements.

Meanwhile, a federal judge is expected to rule soon on separate legal challenges to Arkansas’ and Kentucky’s requirements.

Under Ohio’s plan, the nearly 700,000 adults who gained coverage under Ohio’s 2014 expansion of Medicaid will be required to work at least 20 hours a week, attend school or job training, or lose health coverage. State officials project as many as 36,000 Ohioans could lose Medicaid coverage for failing to meet the requirement.

Most of the expansion population, they say, is already working or exempt from the requirement. The state is exempting those who are over age 50, in treatment for drug or alcohol addiction, have severe health-care needs or serious mental illness.

New enrollees must meet the requirement before they can receive benefits and current enrollees must do so during their annual eligibility review.

John Corlett, president and executive director of the Center for Community Solutions and a former Ohio Medicaid director, called approval of the work requirements “disappointing.”

“According to the state of Ohio’s own extensive, independently conducted research, Ohio’s Medicaid program enabled hundreds of thousands of Ohioans to get and stay healthy. Healthy Ohioans can keep their jobs and take care of their families without fear of choosing between their health and other necessities like food or rent,” Corlett said.

Wendy Patton, senior policy director for Policy Matters Ohio, said the work requirements aren’t necessary, don’t make sense in today’s low-wage job market, put an unfair burden on patients and could be unconstitutional.

She estimated that 61 percent of Medicaid beneficiaries already work. The rest are either students, people with disabilities, early retirees, job seekers or people caring for a loved one with a disability. Many work in low-paying industries like retail or fast food, which offer low and inconsistent hours, have seasonal jobs, and could easily fall short of the 80-hour-a-month work requirement.

Rea S. Hederman Jr., executive director of the Economic Research Center and vice president of policy at The Buckeye Institute, praised the decision.

It’s “an important step in reforming the state’s health care system. The Buckeye Institute’s research shows that with these work requirements many Ohioans will see higher earnings over their lifetimes and they will gain valuable work experience by remaining connected to the workforce.”

It’s unclear when Ohio will impose the new requirements. But one Republican lawmaker is pushing for stricter regulations.

Sen. Matt Huffman of Lima recently introduced legislation to require Medicaid recipients 18 to 65 years old to work at least 20 hours a week to qualify for benefits, arguing that people are quitting their jobs to receive tax-funded health care. There would be exemptions for those: attending college or in a job-training program; in an alcohol- or drug-addiction treatment program; deemed by a doctor to be physically or mentally unfit for employment; or caring for a child under age 1 or a child with a medical condition or disability.

If approved, Senate Bill 25 would require state officials to submitted a new proposal to federal regulators for approval.

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